Caregiver Burden in Pulmonary Patients.

Caregiving has become an increasingly important medical and social issue in recent decades. We performed a cross-sectional study on pulmonary patients and accompanying informal caregivers who were hospitalized in the chest disease ward of a tertiary center in Turkey between January 2020 and April 2021. Informal caregivers were asked to complete the Zarit Caregiver Burden Interview. A total of 141 inpatients (39% female, mean age: 76.8 ± 10.2 years) and their informal caregivers (77% female, mean age: 54 ± 11.9 years) were evaluated. The caregivers were classified as light to medium burden (group 1, burden score ≤40) and medium to heavy burden (group 2, burden score >40). The mean burden score was 35.7 ± 13.3 points. The number of female caregivers was higher in group 2 (p = 0.025). There was a positive correlation between the burden score and female gender (p = 0.002) and the number of chronic diseases of caregivers (p = 0.020). Statistical analysis revealed a negative correlation between the burden score and the level of education (r = > -0.174, p = 0.040). Caregiver burden is related to the characteristics of the caregiver rather than those of the patient being cared for. Female caregivers with lower education and more than one chronic disease perceive a higher caregiver burden.

The value of the platelet count and platelet indices in differentiation of COVID-19 and influenza pneumonia.

It is difficult to distinguish coronavirus disease-2019 (COVID-19) from other viral respiratory tract infections owing to the similarities in clinical and radiological findings. This study aims to determine the clinical importance of platelet count and platelet indices in the differentiation of COVID-19 from influenza and the value of these parameters in the differential diagnosis of COVID-19. The medical records of the patients and the electronic patient monitoring system were retrospectively analyzed. Demographic characteristics, admission symptoms, laboratory findings, radiological involvement, comorbidities, and mortality of the patients were recorded. Forty-three patients diagnosed with influenza and 54 diagnosed with COVID-19 were included in the study. The average age of the COVID-19 patients was lower than that of the influenza patients (influenza: 60.5 years, COVID-19: 52.4 years; pp = 0.024),.024), and the male gender was predominant in the COVID-19 group (influenza: 42%, COVID-19: 56%). According to laboratory findings, the mean platelet volume (MPV) and MPV/platelet ratio were statistically significantly lower, whereas the eosinophil count and platelet distribution width levels were significantly higher (p < 0.05) in the COVID-19 group. It was found that the most common symptom in both groups was dyspnea and that the symptom was more prevalent among influenza patients. In the diagnosis of COVID-19, the platelet count and platelet indices are easily accessible, inexpensive, and important parameters in terms of differential diagnosis and can help in the differentiation of COVID-19 from influenza during seasonal outbreaks of the latter.

The Role of Hematological Inflammatory Biomarkers in the Diagnosis of Lung Cancer and in Predicting TNM Stage.

OBJECTIVE: The aim of study is to investigate whether hematological inflammatory biomarkers could be useful to detect patients with lung cancer. METHODS: The contribution of hematological biomarkers to the diagnosis of lung cancer and prediction of TNM was examined. RESULTS: NLR, PLR, MPV values were found to be higher in patients with lung cancer (all p < .001). NLR and PLR were found to be high, MPV was found to be lower in disease of advanced stage (p < .001). CONCLUSIONS: This study found that NLR, PLR and MPV values were significantly higher in patients with lung cancer.

Artificial intelligence applications in pulmonology and its advantages during the pandemic period.

Artificial intelligence, with its increasing data volume, developing technologies, more information processing power and new algorithms, has a wide usage area in all sectors. In the field of health, these technologies is gaining an increasing place every day. Artificial intelligence methods can act as a simulation of the human mind and intelligence, resulting in the analysis and classification of complex data in a short time. Thus, by separating the small differences in the images examined, it can help diagnosis, detect preliminary signs of the disease and predict how the disease will develop. Computer based programs; diagnostic algorithms, surgical support and robotic systems developed on the basis of patient data are increasingly used in the drug development industry. In this study, artificial intelligence applications in the field of health and its use in pulmonology, the place of wearable technologies in our department and the advantages they provide us during the pandemic period were discussed in the light of the literature.

A rare disease; congenital pulmonary airway malformation in an adult.

Congenital pulmonary airway malformation (CPAM), is a rare disease known as a developmental abnormality of the lower respiratory tract. It may occur in the neonatal period due to respiratory distress and patients usually die in the first few months of life. Rarely, it may remain asymptomatic until adulthood. In this study we describe an adult case and present a review of the literature. A 19-year-old male with no relevant medical history was admitted to our clinic with cough and wheeze. The patient had a history of frequent lower respiratory tract infection during childhood. Chest radiograph revealed a diffuse opacity and volume loss in the right hemithorax. High resolution tomography showed hypoplasia of the right hemithorax, multiple cysts in all of the lobes and segments on the right side, ground glass opacity and interlobular septal thickening of the whole right lung parenchyma. Right pneumonectomy was performed with the pre-diagnosis of congenital pulmonary airway malformation and the pathological examination was compatible with CPAM. CPAM is a rare disease in adulthood. We should consider CPAM in the differential diagnosis of patients with frequent recurrent pulmonary infection and cystic lung lesions. In order to prevent infections and to eliminate the risk of malignancy, surgical treatment should be applied for definite diagnosis and treatment.

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA).

INTRODUCTION: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. MATERIALS AND METHODS: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. RESULT: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency. CONCLUSIONS: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.

[Causes of mediastinal/hilar granulomatous lymphadenitis]. / Mediastinal/hiler granülomatöz lenfadenit etyolojisi.

INTRODUCTION: Granulomatous lung disease (GLD) is caused by a wide range of conditions and it is challenge for pulmonologist. A detailed history of exposures is fundamental in GDL and has been found pivotal to reach a precise diagnosis. MATERIALS AND METHODS: Between September 2014 and December 2016, the distribution of patients diagnosed with granulomatous lymphadenitis in the mediastinal/hilar lymph nodes by endobronchial ultrasound (EBUS) or mediastinoscopy was analyzed. To be listed as 'confident', a diagnosis of sarcoidosis required compatible histological, radiological and clinical findings in conjunction with negative cultures. Infectious entities listed as 'confident' had either microorganisms in tissue section, positive culture, positive serology or positive antigen detection in a consistent clinical pathological setting. RESULT: Granulomatous lymphadenitis was detected in 110 patients. The included 110 cases consisted of 70.9% women and median age of 53 (range 44-61) years. The final diagnosis of the patients was accepted to be sarcoidosis in 79 (71.8%), sarcoid like granulomas in 7 (6.4%), tuberculosis in 4 (3.6%), silicosis in 4 (3.6%), drug-associated granuloma in 2 (1.8%), hypersensitivity pneumonitis in 1 (0.9%), Chron disease in 1 (0.9%), unspecified in 12 (10.9%). Three patients were classified as tuberculosis based on culture. CONCLUSIONS: In this study, we found that the most common cause of granulomatous lymphadenitis was sarcoidosis. Contrary to expectations, the number of patients diagnosed with tuberculosis was very low.

Sleep disturbances in patients with lung cancer in Turkey.

INTRODUCTION: Sleep quality is known to be associated with the distressing symptoms of cancer. The purpose of this study was to analyze the impact of cancer symptoms on insomnia and the prevalence of sleep-related problems reported by the patients with lung cancer in Turkey. MATERIALS AND METHODS: Assesment of Palliative Care in Lung Cancer in Turkey (ASPECT) study, a prospective multicenter study conducted in Turkey with the participation of 26 centers and included all patients with lung cancer, was re-evaluated in terms of sleep problems, insomnia and possible association with the cancer symptoms. Demographic characteristics of patients and information about disease were recorded for each patient by physicians via face-to-face interviews, and using hospital records. Patients who have difficulty initiating or maintaining sleep (DIMS) is associated with daytime sleepiness/fatigue were diagnosed as having insomnia. Daytime sleepiness, fatigue and lung cancer symptoms were recorded and graded using the Edmonton Symptom Assessment Scale. RESULT: Among 1245 cases, 48.4% reported DIMS, 60.8% reported daytime sleepiness and 82.1% reported fatigue. The prevalence of insomnia was 44.7%. Female gender, patients with stage 3-4 disease, patients with metastases, with comorbidities, and with weight loss > 5 kg had higher rates of insomnia. Also, patients with insomnia had significantly higher rates of pain, nausea, dyspnea, and anxiety. Multivariate logistic regression analysis showed that patients with moderate to severe pain and dyspnea and severe anxiety had 2-3 times higher rates of insomnia. CONCLUSIONS: In conclusion, our results showed a clear association between sleep disturbances and cancer symptoms. Because of that, adequate symptom control is essential to maintain sleep quality in patients with lung cancer.

[Bilateral total lung lavage in a patient with pulmonary alveolar proteinosis]. / Pulmoner alveoler proteinozisli hastada iki tarafli total akciger lavaji.

Pulmonary alveolar proteinosis (PAP) is a rare pulmonary disease characterised by alveolar accumulation of surfactant composed of proteins and lipids. Three main categories of PAP have been defined depending on the aetiology: primer/idiopathic, neonatal/congenital, secondary and exogenous/environmental exposure. Radiologically diffuse ground glass opacities, interlobular and intralobular septal thickening is seen. Although open lung biopsy is accepted as the gold standard in diagnosis, it can be diagnosed by showing bronchoalveolar lavage (BAL) fluid with a milky appearance and periodic acid-schiff (PAS) positive globules in biopsy with clinical and radiological findings. Theraphy for PAP are supportive care (oxygen), total lung lavage, inhale/subcutaneous granulocyte macrophage colony stimulating factor (GM-CSF), rituximab, plasmapheresis, lung transplantation. We report a case of PAP presented with cough and shortness of breath, diagnosed with BAL and transbronchial lung biopsy, treated by total lung lavage by reviewing literature.

[A newly-defined entity: combined pulmonary fibrosis and emphysema syndrome]. / Yeni tanimlanan bir antite: Kombine pulmoner fibrozis ve amfizem sendromu.

Combined pulmonary fibrosis and emphysema (CPFE) syndrome is a rare disease characterized with shortness of breath, upper lobe emphysema, lower lobe fibrosis and impairment of gas exchange. This syndrome is a disease usually seen in male smokers. Pulmonary hypertension is associated with mortality. Another important feature, spirometric volumes relatively protected and a reduction in carbon monoxide diffusion test. CPFE syndrome in the literature so far have been identified in only 70 patients. In this review CPFE syndrome is presented with literature.

Long COVID: A risk factor for anxiety, depression, and suicidality?

In many COVID-19 survivors, symptoms continue for a long time. This study aims to examine the relationship between the long-term effects of COVID-19, levels of anxiety and depression, and suicidal ideation with sociodemographic factors and symptoms. A cross-sectional study was conducted on patients who came for control at least 3 months after having COVID-19 disease, in the stable period, and still have symptoms after COVID-19. Demographic characteristics, symptoms, The Beck Depression Scale (BDS), The Beck Anxiety Scale (BAS), and suicidal ideation were assessed with face-to-face questionnaires. A total of 490 patients participated in the study. Thirty percent of patients scored positive on the BDS and 46% scored high on the BAS. Female sex was found to be a risk factor. Anxiety and depression were found to be significantly associated with long COVID symptoms. Both BAS and BDS scores were significantly higher in people with suicidality compared to others, and long-term symptoms were found to be statistically associated with this situation. Depression and anxiety are common in cases of long COVID. It is important for healthcare professionals to be aware of these potential mental health consequences, especially suicidality, and to provide appropriate support and interventions for individuals with long COVID.

Computed tomography attenuation in differential diagnosis of transudative and exudative pleural effusions.

OBJECTIVE: Pleural effusion is a common medical problem. It is important to decide whether the pleural fluid is a transudate or an exudate. This study aims to measure the attenuation values of pleural effusions on thorax computed tomography and to investigate the efficacy of this measurement in the diagnostic separation of transudates and exudates. MATERIALS AND METHODS: 380 cases who underwent thoracentesis and thorax computed tomography with pleural effusion were classified as exudates or transudates based on Light's criteria. Attenuation measurements in Hounsfield units were performed through the examination of thorax computed tomography images. RESULTS: 380 patients were enrolled (39 % women), the mean age was 69.9 ± 15.2 years. 125 (33 %) were transudates whereas 255 (67 %) were exudates. The attenuation values of exudates were significantly higher than transudates (15.1 ± 5.1 and 5.0 ± 3.4) (p < 0.001). When the attenuation cut-off was set at ≥ 10 HU, exudates were differentiated from transudates at high efficiency (sensitivity is 89.7 %, specificity is 94.4 %, PPV is 97 %, NPV is 81.9 %). When the cut-off value was accepted as < 6 HU, transudates were differentiated from exudates with 97.2 % specificity. CONCLUSION: The attenuation measurements of pleural fluids can be considered as an efficacious way of differentiating exudative and transudative pleural effusions.

Clinical Course of Coronavirus disease 2019 C-19 in Patients with Bronchiectasis.

Objective: Coronavirus disease 2019 (COVID-19) has affected the whole world and caused the death of more than 6 million people. The disease has been observed to have a more severe course in patients with chronic lung diseases. There are limited data regarding COVID-19 in patients with bronchiectasis. The aim of this article is to investigate the course of COVID-19 and factors affecting the clinical outcome in patients with bronchiectasis. Material and Methods: This study was conducted using the Turkish Adult Bronchiectasis Database (TEBVEB) to which 25 centers in Türkiye contributed between March 2019 and January 2022. The database consisted of 1035 patients, and COVID-19-related data were recorded for 606 patients. Results: One hundred nineteen (19.6%) of the bronchiectasis patients (64 female, mean age 57.3 ± 13.9) had COVID-19. Patients with bronchiectasis who developed COVID-19 more frequently had other comorbidities (P = .034). They also more frequently had cystic bronchiectasis (P = .009) and their Bronchiectasis Severity Index was significantly higher (P = .019). Eighty-two (68.9%) of the patients who had COVID-19 were followed up in the outpatient clinic, 27 (22.7%) in the inpatient ward and 10 (8.4%) patients in the intensive care unit. There tended to be a higher percentage of males among patients admitted to the hospital (P = .073); similarly, the mean age of the patients admitted to the hospital was also higher (60.8 vs 55.8 years for the outpatients), but these differences did not reach statistical significance (P = .071). Conclusion: In conclusion, this study showed that severe bronchiectasis, presence of cystic bronchiectasis and worse Bronchiectasis Severity Index are associated with the development of COVID-19, but not with the severity of infection.

Post-COVID Interstitial Lung Disease: How do We Deal with This New Entity?

Background: In the postacute phase of coronavirus disease-2019 (COVID-19), survivors may have persistent symptoms, lung function abnormalities, and sequelae lesions on thoracic computed tomography (CT). This new entity has been defined as post-COVID interstitial lung disease (ILD) or residual disease. Aims: To evaluate the characteristics, risk factors and clinical significance of post-COVID ILD. Study Design: Multicenter cross-sectional analysis of data from a randomized clinical study. Methods: In this study, patients with persistent respiratory symptoms 3 months after recovery from COVID-19 were evaluated by two pulmonologists and a radiologist. post-COVID ILD was defined as the presence of respiratory symptoms, hypoxemia, restrictive defect on lung function tests, and interstitial changes on follow-up high-resolution computed tomography (HRCT). Results: At the three-month follow-up, 375 patients with post-COVID-19 syndrome were evaluated, and 262 patients were found to have post-COVID ILD. The most prevalent complaints were dyspnea (n = 238, 90.8%), exercise intolerance (n = 166, 63.4%), fatigue (n = 142, 54.2%), and cough (n = 136, 52%). The mean Medical Research Council dyspnea score was 2.1 ± 0.9, oxygen saturation was 92.2 ± 5.9%, and 6-minute walking distance was 360 ± 140 meters. The mean diffusing capacity of the lung for carbon monoxide was 58 ± 21, and the forced vital capacity was 70% ± 19%. Ground glass opacities and fibrotic bands were the most common findings on thoracic HRCT. Fibrosis-like lesions such as interlobular septal thickening and traction bronchiectasis were observed in 38.3% and 27.9% of the patients, respectively. No honeycomb cysts were observed. Active smoking [odds ratio (OR), 1.96; 95% confidence interval (CI), 1.44-2.67), intensive care unit admission during the acute phase (OR, 1.46; 95% CI, 1.1-1.95), need for high-flow nasal oxygen (OR, 1.55; 95% CI, 1.42-1.9) or non-invasive ventilation (OR, 1.31; 95% CI, 0.8-2.07), and elevated serum lactate dehydrogenase levels (OR, 1.23; 95% CI 1.18-1.28) were associated with the development of post-COVID ILD. At the 6-month follow-up, the respiratory symptoms and pulmonary functions had improved spontaneously without any specific treatment in 35 patients (13.4%). The radiological interstitial lesions had spontaneously regressed in 54 patients (20.6%). Conclusion: The co-existence of respiratory symptoms, radiological parenchymal lesions, and pulmonary functional abnormalities which suggest a restrictive ventilatory defect should be defined as post-COVID-19 ILD. However, the term "fibrosis" should be used carefully. Active smoking, severe COVID-19, and elevated lactate dehydrogenase level are the main risk factors of this condition. These post-COVID functional and radiological changes could disappear over time in 20% of the patients.

Pulmonary Physician Consultancy in Emergency Services in Turkiye (PuPCEST) - a cross-sectional multicenter study.

Pulmonology is one of the branches that frequently receive consultation requests from the emergency department. Pulmonology consultation (PC) is requested from almost all clinical branches due to the diagnosis and treatment of any respiratory condition, preoperative evaluation, or postoperative pulmonary problems. The aim of our study was to describe the profile of the pulmonology consultations received from emergency departments in Turkiye. A total of 32 centers from Turkiye (the PuPCEST Study Group) were included to the study. The demographic, clinical, laboratory and radiological data of the consulted cases were examined. The final result of the consultation and the justification of the consultation by the consulting pulmonologist were recorded. We identified 1712 patients, 64% of which applied to the emergency department by themselves and 41.4% were women. Eighty-five percent of the patients had a previously diagnosed disease. Dyspnea was the reason for consultation in 34.7% of the cases. The leading radiological finding was consolidation (13%). Exacerbation of preexisting lung disease was present in 39% of patients. The most commonly established diagnoses by pulmonologists were chronic obstructive pulmonary disease (19%) and pneumonia (12%). While 35% of the patients were discharged, 35% were interned into the chest diseases ward. The majority of patients were hospitalized and treated conservatively. It may be suggested that most of the applications would be evaluated in the pulmonology outpatient clinic which may result in a decrease in emergency department visits/consultations. Thus, improvements in the reorganization of the pulmonology outpatient clinics and follow-up visits may positively contribute emergency admission rates.

Lung cancer detection based on computed tomography image using convolutional neural networks.

BACKGROUND: Lung cancer is the most common type of cancer, accounting for 12.8% of cancer cases worldwide. As initially non-specific symptoms occur, it is difficult to diagnose in the early stages. OBJECTIVE: Image processing techniques developed using machine learning methods have played a crucial role in the development of decision support systems. This study aimed to classify benign and malignant lung lesions with a deep learning approach and convolutional neural networks (CNNs). METHODS: The image dataset includes 4459 Computed tomography (CT) scans (benign, 2242; malignant, 2217). The research type was retrospective; the case-control analysis. A method based on GoogLeNet architecture, which is one of the deep learning approaches, was used to make maximum inference on images and minimize manual control. RESULTS: The dataset used to develop the CNNs model is included in the training (3567) and testing (892) datasets. The model's highest accuracy rate in the training phase was estimated as 0.98. According to accuracy, sensitivity, specificity, positive predictive value, and negative predictive values of testing data, the highest classification performance ratio was positive predictive value with 0.984. CONCLUSION: The deep learning methods are beneficial in the diagnosis and classification of lung cancer through computed tomography images.

Deep learning for diagnosis of malign pleural effusion on computed tomography images.

BACKGROUND: The pleura is a serous membrane that surrounds the lungs. The visceral surface secretes fluid into the serous cavity and the parietal surface ensures a regular absorption of this fluid. If this balance is disturbed, fluid accumulation occurs in the pleural space called "Pleural Effusion". Today, accurate diagnosis of pleural diseases is becoming more critical, as advances in treatment protocols have contributed positively to prognosis. Our aim is to perform computer-aided numerical analysis of Computed Tomography (CT) images from patients showing pleural effusion images on CT and to examine the prediction of malignant/benign distinction using deep learning by comparing with the cytology results. METHODS: The authors classified 408 CT images from 64 patients whose etiology of pleural effusion was investigated using the deep learning method. 378 of the images were used for the training of the system; 15 malignant and 15 benign CT images, which were not included in the training group, were used as the test. RESULTS: Among the 30 test images evaluated in the system; 14 of 15 malignant patients and 13 of 15 benign patients were estimated with correct diagnosis (PPD: 93.3%, NPD: 86.67%, Sensitivity: 87.5%, Specificity: 92.86%). CONCLUSION: Advances in computer-aided diagnostic analysis of CT images and obtaining a pre-diagnosis of pleural fluid may reduce the need for interventional procedures by guiding physicians about which patients may have malignancies. Thus, it is cost and time-saving in patient management, allowing earlier diagnosis and treatment.

Perceived Need for Mental Health Services Among Healthcare Workers During the Coronavirus Disease-19 Pandemic in Turkey: A Multicenter Cross-sectional Study

Background: The coronavirus disease-2019 pandemic has contributed to work-related psychosocial risks in healthcare workers. Aims: To evaluate the perceived need for mental health services and related factors in Turkish healthcare workers practicing in pandemic hospitals. Study Design: Cross-sectional study. Methods: Data were collected from face-to-face interviews with healthcare workers at 19 pandemic hospitals in 13 provinces between September and November 2021. The study survey included the evaluation of the perceived need for and utilization of mental health services in the previous year, as well as sociodemographic, health-related, and work-related characteristics, the General Health Questionnaire-12, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, and the Fear of coronavirus disease-2019 scale (FCV-19S). Results: Of 1,556 participants, 522 (33.5%) reported a perceived need for mental health services, but only 133 (8.5%) reported receiving these services. Multiple logistic regression analysis of the perceived need for mental health services revealed significant relationships with lower age, female sex, being a current smoker, having a chronic disease, having a mental disorder, coronavirus disease-2019 contact within the last three months in settings other than the home or workplace, a positive coronavirus disease-2019 vaccination history, being a physician, being a non-physician healthcare professional, and coronavirus disease-2019 contact within the last three months at work. After adjustment for these characteristics, higher General Health Questionnaire-12 and FCV-19S scores and lower WHOQoL-BREF domain scores were related to the perceived need for mental health services in logistic regression analyses. Conclusion: The findings indicate a substantial need for mental health services amongst Turkish healthcare workers during the pandemic and outline participants' characteristics regarding high-priority groups for the intervention. Future research may focus on developing actions and evaluating their efficiency.

Evaluation of Thiol/Disulfide Homeostasis in Bronchiectasis.

PURPOSE: Thiols are sulfhydryl-containing organic compounds that have an important role in preventing cellular oxidative stress. This study compares the blood oxidative stress marker levels in bronchiectasis cases during their stable periods with healthy controls. MATERIALS AND METHODS: Seventy-seven patients (49 patients with stable bronchiectasis/28 healthy controls), followed up by the chest disease clinic, were included in the study. Peripheral blood thiol-disulfide parameters (NT: native thiol (-SH); TT: total thiol (-SH + SS); SS: disulfide (-SS); SS-SH: disulfide/native thiol index; SS-TT: disulphide/total thiol index; SH-TT: native thiol/total thiol index), and ischemia-modified albumin (IMA) levels were examined in the stable bronchiectasis group and the control group. Thiol-disulfide homeostasis was evaluated using a novel and automated assay. Findings and Result. Blood native thiol levels in patients with stable bronchiectasis were found to be significantly higher compared with healthy controls. A positive correlation between the total airway disease score and IMA levels was present. Our findings revealed that native thiol levels, which constitute a part of the antioxidant defense system, are increased in patients with stable bronchiectasis.

'COVID-Somnia' in healthcare workers during the pandemic.

OBJECTIVES: Sleep disorders associated with COVID-19 pandemic are termed as 'COVID-somnia.' In this study, we sought to assess the prevalence of COVID-somnia in healthcare workers, establish the factors that trigger this condition, and to investigate its relationship with anxiety and depression symptoms. METHODS: This cross-sectional study was conducted between April 2021 and June 2021, and it included healthcare workers who served during the pandemic. Participants' demographic data, Beck Depression and Anxiety Inventories, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index (ISI) were used, and the results were statistically analyzed. Multiple analyses of factors affecting ESS and ISI scores were evaluated using binary logistic regression model and PSQI score were analyzed using a multiple linear regression model. RESULTS: A total of 1,111 healthcare workers who served during the pandemic voluntarily enrolled to the study. The mean age was 37.3 ± 8.48 years, and 63.5% were females. Our study showed that the healthcare workers, evaluated with the PSQI, experienced a deterioration of sleep quality. Primary factors affecting this are working on the front line, the presence of chronic diseases, depression, and anxiety. Regression analyses identified depression and anxiety as the common factors affecting ESS, ISI, and PSQI scores. CONCLUSION: Raising awareness regarding COVID-somnia among healthcare workers, who play a leading role in curbing the pandemic, would reduce sleep disturbances, depression, and anxiety. It would also contribute to the planning and implementation of preventive and therapeutic mental health programs with a multidisciplinary approach.